Issues in complementary and alternative medicine
Issues in complementary and alternative medicine

This free course is available to start right now. Review the full course description and key learning outcomes and create an account and enrol if you want a free statement of participation.

Free course

Issues in complementary and alternative medicine

2.9 The failure of CAM therapeutic relationships: creating dependency to satisfy practitioners' emotional and financial needs

Although a failed therapeutic relationship is often assumed to involve a patient not returning, the case of a patient who attends repeatedly can also be highly problematic. This phenomenon can be seen as a breach of boundaries in that an inappropriately extended therapeutic relationship changes from being a healing encounter into a dependency relationship or friendship. Unlike the timescale contracts that may be negotiated in counselling and psychotherapy, there are no fixed timescales for most CAM therapies. Some CAM users will continue to attend as and when they feel like it, especially when the CAM therapies have a strong leisure or relaxation component, such as massage or aromatherapy. In the more ‘medicalised’ therapies, practitioners usually indicate to users the timescale in which they hope to see some improvement. Negotiating an appropriate timeframe helps patients to feel in control, and gives a realistic period in which to judge whether the treatment is beneficial.

Figure 4
The Wellcome Trust ©
The Wellcome Trust
Figure 4

Other CAM therapies are based on the notion of minimum intervention. For example, in osteopathy the general aim of the treatment is that patients are not long term. Once a lack of improvement or a levelling off is observed then the practitioner is expected to help the patient end the treatment. Of course, some patients will return for ‘top-up’ sessions, or when a condition flares up. However, research by the British School of Osteopathy suggests that returning patients are quite common (Pringle and Tyreman, 1993).

Practitioners are often at a loss to know where to send patients who report they are not getting better. In some cases, practitioners think these patients have no one else to turn to and that they have an ongoing duty to relieve the patients’ distress, even though they cannot offer a cure. This raises interesting issues about what therapy is really for, and how attendance may be affected by lack of support or care for particular patient groups in orthodox services. Continually returning patients are the subject of a considerable literature in orthodox health care and they are often called ‘heart sink’ patients (for example, Pietroni and Chase, 1993; O'Rourke, 2000). The ‘returnee’ may be CAM's equivalent.

K221_1

Take your learning further

Making the decision to study can be a big step, which is why you'll want a trusted University. The Open University has over 40 years’ experience delivering flexible learning and 170,000 students are studying with us right now. Take a look at all Open University courses.

If you are new to university level study, find out more about the types of qualifications we offer, including our entry level Access courses and Certificates.

Not ready for University study then browse over 900 free courses on OpenLearn and sign up to our newsletter to hear about new free courses as they are released.

Every year, thousands of students decide to study with The Open University. With over 120 qualifications, we’ve got the right course for you.

Request an Open University prospectus